POS0507 TAILORING ORAL THERAPY IN RHEUMATOID ARTHRITIS: THE TuTOR APP
Authors: M. Radin, M. Arbrile, I. Cecchi, A. Barinotti, S. Baldovino, E. Menegatti, D. Rossi, S. Sciascia, D. Roccatello
Journal: Annals of the Rheumatic Diseases (2022)

Background Medication non-adherence has a significant impact on the health and well-being of individuals with chronic diseases. Indeed, with respect to important risk factors of Rheumatoid Arthritis (RA), such as cardiovascular risk factors, it is known that up to 50% of patients will stop taking medication for these conditions during the first year of prescription [1]. Objectives To support the management of RA patients treated with Tofacitinib, we designed the TuTOR (Tailoring Tofacitinib Oral therapy in Rheumatoid arthritis) Mobile App. Methods A prospective-controlled study evaluated the impact of TuTOR App on medical adherence in 20 RA patients, that began treatment with Tofacitinib jointly with the App. We used a crossover design alternating Paper-Diary and TuTOR App, with monthly clinical assessments. Results Seventeen patients with RA (mean age at inclusion 59±13yrs; 88% females) the study. A statistically significant decrease of DAS28 was observed since the first month of therapy with Tofacitinib (mean DAS28 at baseline 3.9±1 vs. 1° month 3.1±1, p=0.0016). Similarly, Numerical Rating Scale(NRS) of perceived activity of disease (5.8±2.1 vs.3.7±2.5, p=0.02), and subjective fatigue (6.1±2.3 vs 4.3±2.6; p=0.01) progressively decreased. No differences were reported in DAS28 and in all the NRS between the use of the TuTOR App and the Paper-Diary. A significant decrease was observed also in HAQ during the follow-up (baseline 1.38±1.11 vs.six months 0.83±0.9; p=0.01). Most of the patients (82%) when filling out the self-reporting questionnaires preferred the TuTOR App in helping them to remember to take the pills. Further 82% of patients used the TuTOR App regularly (vs.53% Paper-Diary) and 76% of patients would use it in the future (vs.53% Paper-Diary). Three patients suspended the therapy with Tofacitinib due to gastrointestinal intolerance. Conclusion Both digital- and paper-devices can help maximize the adherence to therapy, leading to an improvement in disease’s activity, highlighting the need of supports for medication adherence. References [1]BJ van den B, HE Z, CH van den E. Medication adherence in patients with rheumatoid arthritis: a critical appraisal of the existing literature. Expert Rev Clin Immunol 2012;8:337–351. Available at: https://pubmed.ncbi.nlm.nih.gov/22607180/ . Accessed July 13, 2021. Table 1. Baseline demographic and clinical characteristics of the patients enrolled in the study, who completed follow-up. RA – Rheumatoid Arthritis Patients with RA (N=17) DEMOGRAPHICS Age (mean ± S.D. ) 59,4 ± 13,5 Sex (n; % ) M (2; 11,8), F (15; 88,2) Etnicity (caucasian; n; % ) 16; 94 Etnicity (Hispanic; n; % ) 1; 6 CLINICAL CHARACTERISTICS Age at diagnosis (mean ± S.D. ) 44,7±14,47 Follow-up length (years; mean ± S.D. ) 6,33± 5,17 Positive Rheumatoid Factor (n; % ) 17; 100 Positive Anti-Cyclic citrullinated peptides (n;% ) 15; 88.2 Structural articular damage at radiography (n; % ) 11; 7 Figure 1. Decrease of disease activity assessed by DAS28 in the paper-diary and TuTOR App groups. Disclosure of Interests Massimo Radin Grant/research support from: The study is supported by the Investigator-Initiated Research Studies Grant—CREARE (Pfizer)., Marta Arbrile: None declared, Irene Cecchi Grant/research support from: The study is supported by the Investigator-Initiated Research Studies Grant—CREARE (Pfizer)., Alice Barinotti: None declared, Simone Baldovino: None declared, Elisa Menegatti: None declared, Daniela Rossi Grant/research support from: The study is supported by the Investigator-Initiated Research Studies Grant—CREARE (Pfizer)., Savino Sciascia Grant/research support from: The study is supported by the Investigator-Initiated Research Studies Grant—CREARE (Pfizer)., Dario Roccatello Grant/research support from: The study is supported by the Investigator-Initiated Research Studies Grant—CREARE (Pfizer).